Newly Described Condition Seen in Patients With TBI

Pavankumar Kamat

December 30, 2020

Researchers for the first time have reported a condition known as 'vestibular agnosia' causing loss of vertigo perception and imbalance in patients with traumatic brain injury (TBI). The findings were published in the journal  Brain.

Vestibular agnosia causes both loss of vertigo perception and imbalance because of neural circuit damage in the right temporal lobe of the brain.

In a small study, a team of researchers at the Imperial College London and clinicians at Imperial College Healthcare NHS Trust prospectively assessed 37 patients with acute TBI and 37 matched controls.

Fifteen of the 37 patients with TBI had vestibular agnosia and 10 of them showed little or no perception of vertigo. Additionally, 16 of the 37 patients had benign paroxysmal positional vertigo.

The findings indicate that patients with TBI and vestibular agnosia have worse balance problems than TBI patients without vestibular agnosia and are not likely to experience dizziness - a key factor to assess balance problems in patients with TBI. Consequently, clinicians have a seven times higher likelihood of missing cases of balance dysfunction in TBI patients with vestibular agnosia than in those without the condition.

Dr Barry Seemungal who led the study said: “Our study is the first to identify loss of vertigo in some TBI patients and explain why they have balance problems and falls. This finding could lead to the development of new treatments and diagnostic tests.”

Calzolari E, Chepisheva M, Smith RM, Mahmud M, Hellyer PJ, Tahtis V, Arshad Q, Jolly A, Wilson M, Rust H, Sharp DJ, Seemungal BM. Vestibular agnosia in traumatic brain injury and its link to imbalance. Brain. 2020 Dec 26 [Epub ahead of print]. doi: 10.1093/brain/awaa386. PMID: 33367536 View full text

This article originally appeared on Univadis, part of the Medscape Professional Network.

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